Predictors of Clinical Outcomes After Hip Arthroscopy: A Prospective Analysis of 1038 Patients With 2-Year Follow-up

Domb, Benjamin G.; Martin, Timothy J.; Gui, Chengcheng; Chandrasekaran, Sivashankar; Suárez-Ahedo, Carlos; Lodhia, Parth

doi:10.1177/0363546518763362

Cited by 111 publications

(109 citation statements)

References 55 publications

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“…Some studies have also identified BMI as a risk factor for poorer patient-reported and clinical outcomes. 12 , 13 , 16 , 27 , 31 Wolfson et al. 12 noted that female sex and BMI >30 were associated with lower rates of achieving a MCID or PASS.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Conversion of Hip Arthroscopy to Total Hip Arthroplasty: A Large Closed-Cohort Study

Allahabadi

Hinman

Horton

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To evaluate risk factors for conversion of hip arthroscopy to total hip arthroplasty (THA) within 2 years in a closed patient cohort. Methods This study was a case series of consecutive hip arthroscopy procedures from September 2008 to November 2018 in the electronic medical record of Kaiser Permanente Northern California. Patients were included with minimum 2-year follow-up or if they had conversion to THA within 2 years (the primary outcome) regardless of follow-up time. Patient characteristics at the time of the index arthroscopy were extracted; characteristics of patients who experienced the outcome event versus those who did not were compared by use of multivariable logistic regression models and receiver operating characteristic (ROC) curves. Results The mean follow-up time was 4.9 years (median 4.6, range 0.6 to 11.6). The mean age was 37.2 years (range 10 to 88), and 57% were female. During the follow-up period, 82 patients underwent a THA within 2 years of their arthroscopies (5.3%, 95% confidence interval 4.3% to 6.5%) after a median time of 9 months (interquartile range 5.9 to 14.4) after the initial arthroscopy. Increasing age was highly predictive of early THA conversion (area under the ROC curve = 0.78, P < .001). Although other predictors showed significant bivariable associations with early failure, body mass index (BMI), race, sex, and prior arthroscopy did not add meaningful independent predictive information. Conclusions The risk of conversion to THA within 2 years after hip arthroscopy increased substantially with patient age at the time of the procedure. BMI, race, sex, and prior arthroscopy were not important independent predictors of conversion beyond the information contained in patient age. Level of Evidence Level IV, therapeutic case series.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Conversion of Hip Arthroscopy to Total Hip Arthroplasty: A Large Closed-Cohort Study

Allahabadi

Hinman

Horton

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…O ver the past decade, hip arthroscopy has become a routine procedure for the surgical treatment of femoroacetabular impingement syndrome (FAIS), with favorable outcomes and high success rates at short-, mid-, and long-term follow-up. [1][2][3][4][5][6][7][8][9] Yet, as with all orthopaedic procedures, rate of recovery and outcomes are highly influenced by patient-specific factors, including age, sex, body habitus, and arthritic changes. 10,11 Increasing evidence has demonstrated that outcomes of orthopaedic procedures also depend on patient psychological traits, which can affect compliance, rehabilitation effort, and pain perception.…”

mentioning

confidence: 99%

What is the Role of Kinesiophobia and Pain Catastrophizing in Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome?

Clapp

Nwachukwu

Beck

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To (1) investigate trends in kinesiophobia and pain catastrophizing after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), and (2) determine whether kinesiophobia and pain catastrophizing scores are associated with achieving minimal clinically important difference (MCID) for any of the hip-specific patient-reported outcome questionnaires. Methods: Patients undergoing primary hip arthroscopy for treatment of FAIS between December 2016 and March 2017 were prospectively enrolled. Patients received the Tampa Scale of Kinesiophoibia-11 (TSK-11) and Pain Catastrophizing Scale (PCS) questionnaires preoperatively, 6 months, and 1 year postoperatively. They also received the hip-specific patient-reported outcome questionnaires (Hip Outcome Score Activities of Daily Living and Sport-Specific subscales, modified Harris Hip Score, and International Hip Outcome Tool-12), as well as visual analog scale for satisfaction and pain preoperatively and 1-year postoperatively. The threshold for achieving MCID was determined for each hip outcome tool, and patients achieving MCID were compared with those who did not. Results: A total of 85 (80.2%) patients (mean age: 33.7 AE 12.4 years; female: 75.3%) were included in the final analysis. At 1-year follow-up, there was a significant reduction in TSK-11 scores (26.22 AE 5.99 to 18.70 AE 6.49; P < .001) and PCS scores (17.81 AE 10.13 to 4.77 AE 7.57; P < .001) when compared with preoperative scores. 1-year PCS scores were significantly lower in patients achieving MCID compared with patients failing to achieve MCID (3.2 AE 4.4 vs 10.8 AE 15.2; P ¼ .006). There were no significant differences in TSK-11 scores between those achieving and not achieving MCID. Conclusions: Patient kinesiophobia and pain catastrophizing both show significant improvements 1 year after undergoing hip arthroscopy for FAIS. However, pain catastrophizing scores at 1 year are significantly greater in patients not achieving MCID, whereas no association was identified between kinesiophobia and likelihood for MCID achievement. This suggests PCS may be a more useful tool than TSK-11 during postoperative rehabilitation for identifying patients at risk for not achieving MCID.

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“…Undoubtedly, the benefit of the resolution of the impingement is limited in cases of cartilaginous lesions of sufficient degree to reduce the joint space below 2 mm. This cartilaginous involvement is currently considered the main limitation and one of the major prognostic factors of treatment failure in this type of hips [6].…”

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confidence: 97%

Chondral Lesions and Stem Cells

Barastegui

2019

Journal of Investigative Surgery

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Predictors of Clinical Outcomes After Hip Arthroscopy: A Prospective Analysis of 1038 Patients With 2-Year Follow-up

Cited by 111 publications

References 55 publications

Risk Factors for Conversion of Hip Arthroscopy to Total Hip Arthroplasty: A Large Closed-Cohort Study

Risk Factors for Conversion of Hip Arthroscopy to Total Hip Arthroplasty: A Large Closed-Cohort Study

What is the Role of Kinesiophobia and Pain Catastrophizing in Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome?

Chondral Lesions and Stem Cells

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